Testicular torsion is an attack on the male genital gland, the testicle. It is the consequence of an anatomical anomaly. This is a therapeutic emergency, the management of which must be immediate.

The testicular torsion corresponds to a winding of the spermatic cord, containing the veins and arteries which allow the irrigation of the testicle, around it. As a result, the irrigation of the testis (male reproductive gland) is interrupted. This therefore risks endangering the life of this gland.

This damage is the consequence of an anatomical anomaly. This can have major consequences and damage the genital gland irreversibly.

Diagnosis, management and surgical intervention must be early and rapid in order to limit any risk of significant deterioration.

In the majority of cases (between 50% and 80%), the disease affects both testicles. In addition, two phases can be distinguished in the development of the disease: during perinatal development and during the post-pubertal phase.

Testicular torsion is the consequence of an anatomical anomaly, of a mechanical deficiency. The disease appears during the development of the fetus and can manifest itself in two forms:

• an abnormality in the attachment of the testis membrane to the bursa: lack of mating
• a deficiency in the resistance between the gland (testis) and the scrotum (bag of skin located between the penis and the anus)

Testicular torsion can affect any male individual, regardless of age. However, the disease tends to appear during fetal development or in the infant stage.

Young children and adolescents also represent a population at greater risk of developing such a pathology. Adults over 40 are less affected by the risk of testicular torsion.

Late diagnosis and management of testicular torsion can have significant consequences. Among those :

• complete inactivity of the genital gland and the need for its removal
• the transplant of a silicone prosthesis

The clinical signs and general symptoms of testicular torsion are manifested by:

• swelling of the bursa with pain and inflammation
• radiating pain in the groin and iliac fossa
• inconvenience to walk
• a risk of nausea, vomiting or discomfort

This is a therapeutic emergency, the management and treatment of which must be immediate.

As soon as clinical signs and characteristic symptoms are observed, recourse to a health professional, or even to the emergency services is essential.

Following the diagnosis, the surgical intervention must be carried out within the following 6 hours. And this, in order to preserve the viability of the gland. This intervention is carried out in several stages:

• untwisting the testicle to restore blood circulation
• attachment of the testicle to the scrotum
• the attachment of each testicle to its own purse.

Following this, close medical supervision is necessary to avoid the risk of atrophy.